Gedarel

Gedarel is a combined oral contraceptive (COC), or what is commonly referred to as ‘the pill’. It contains two different types of female hormone: desogestrel – a progesterone, and ethinylestradiol – an oestrogen. Gedarel comes as a film-coated tablet in two different strengths: 20/150 contains 150 mcg of desogestrel and 20 mcg of ethinylestradiol, while 30/150 contains 150 mcg of desogestrel and 20 mcg of ethinylestradiol.

If you are sexually active, it is a wise precaution to look at the different methods of contraception available to you. There is currently a wide variety of contraceptive options open to both men and women, and deciding on the right one for you may seem complicated. Having a range of options available, however, means that everyone should be able to find a contraceptive option that suits them. From daily pills to weekly patches or longer-term contraceptive devices that can last for five to 10 years, there really is something to suit everyone’s needs, so it is worth spending a little time working out what might be the best solution for you and your body.

Gedarel is a combined oral contraceptive, or what is commonly referred to as ‘the pill’. It contains two different types of female hormone: desogestrel – a progesterone, and ethinylestradiol – an oestrogen. Gedarel comes as a film-coated tablet in two different strengths: 20/150 contains 150 mcg of desogestrel and 20 mcg of ethinylestradiol, while 30/150 contains 150 mcg of desogestrel and 20 mcg of ethinylestradiol.

Gedaral is a form of contraception, i.e. it is used to prevent pregnancy. It is a combined oral contraceptive (meaning it contains more than one hormone).

These hormones work to protect you against pregnancy in three different ways:

• Thickening the fluid at the entrance to the womb, making it hard for the sperm to reach an ovary;
• Stopping the ovaries from releasing eggs every month;
• Altering the lining of the womb so that it is less likely that it accepts a fertilised egg.

Combined oral contraceptives are one of the most effective methods of contraception when taken properly. If taken correctly, the failure rate for Gedarel is only 3 pregnancies per 1,000 women per year. However, often it is not taken correctly, meaning that the actual rate is closer to 90 pregnancies per 1,000 women per year. It is worth remembering this and remembering to follow the doses and instructions for timings properly.

Always take any medication exactly as your doctor or pharmacist has told you to. The Gedarel contraceptive pill comes as a film-coated tablet in a pack containing one calendar strip of 21 tablets or 3, 6 or 13 strips of 21 tablets.

Take the Gedarel contraceptive pill at the same time each day – often first thing in the morning or last thing at night is easier to remember. Swallow the tablets whole with water.

When it comes to taking medicine, always follow the instructions given to you by your doctor or pharmacist. As a general rule the dosage for Gedarel is one tablet every day for 21 days, followed by a rest period of seven days to allow for a period. You then start your next course of 21 tablets on day 8.

Gedarel comes in calendar strips of 21 tablets to help you remember to take your tablet every day. You will start each new strip on the same day of the week and start your period on the same day of the week each month. Start your new pack after seven tablet-free days, even if you are still bleeding.

If you have not been using oral contraception during your previous menstrual cycle:

• Take the first tablet on the first day of your period;
• Make sure you take the tablet from the packet where the correct day of the week is labelled;
• Follow the arrows on the pack as you take the course of tablets;
• If you start taking the tablets on day 2-5 of your period, you will need to use another method of contraception for the first seven days for this first pack.

If you are switching from another COC, or combined contraceptive vaginal ring or patch:

• Start taking Gedarel on the day after the last active tablet, or at the latest the day after your usual tablet-free days;
• After a ring or patch, start on the day you remove your patch or ring, or at the latest when you would next have applied it.

If you are switching from a progesterone-only product (pills, injection, implant, IUD):

• Switch on any day (for implants and IUDs – the day of removal, for the injection – when it would next be due).

In all cases, you will need to use another method of contraception for seven days.

If you forget to take your tablet:

• If you are less than 12 hours late, then your protection from pregnancy is not reduced. Take the tablet as soon as you remember then take your next tablets at your usual time;
• If you are more than 12 hours late the risk of pregnancy is higher – it will depend on how many tablets you have forgotten and the greatest risk is at the beginning or end of the cycle. Take the forgotten tablet as soon as you remember, even if this means taking two tablets at the same time. You should use a condom for seven days of active pill;
• If you forget more than one tablet in a strip contact your doctor.

If you have forgotten any tablet in a strip and you do not bleed during your tablet-free week then you may be pregnant. Contact your doctor before you start the next strip.

As with all medication, the Gedarel contraceptive pill comes with a warning of some side effects, although of course not everyone who takes Gedarel will experience them. All COCs come with a risk of increased risk of blood clots in your veins or arteries which can cause a stroke, heart attack or embolism.

Signs of a blood clot include:

• Swelling in one leg, foot or along the vein;
• Pain or tenderness especially when standing or walking;
• Changes in skin colour on the leg;
• A feeling of warmth on the affected leg;
• Sudden breathlessness;
• Sudden cough with no cause;
• Rapid or irregular heartbeat;
• Sharp chest pain with deep breathing;
• Severe stomach pain;
• Severe dizziness or light- headedness;
• Immediate loss of vision;
• Painless blurring of vision;
• Chest pain, pressure or discomfort;
• Choking feeling;
• Sweating, nausea, vomiting or dizziness;
• Extreme weakness;
• Sudden weakness or numbness in the face, arm or leg;
• Sudden confusion, trouble speaking or understanding;
• Sudden severe or prolonged headache with no known cause;
• Loss of consciousness or fainting with or without a seizure.

If you experience any of the above seek urgent medical assistance.

Very common side effects (may affect more than 1 in 10 people):

• Irregular bleeding.

Common side effects (may affect up to 1 in 10 people):

• Depression;
• Altered mood;
• Nervousness;
• Nausea;
• Abdominal pain;
• Acne;
• Headaches;
• Dizziness;
• Tender or painful breasts;
• Lack of periods;
• Painful periods;
• Worsened PMT;
• Weight gain.

Uncommon side effects (may affect up to 1 in 100 people):

• Lower libido;
• Migraine;
• Hearing problems;
• Fluid retention;
• High blood pressure;
• Diarrhoea;
• Vomiting;
• Rash;
• Breast enlargement.

Rare side effects (may affect up to 1 in 1000 people):

• Higher libido;
• Eye irritation;
• Itching;
• Skin disorders;
• Skin discolouration;
• Vaginal discharge;
• Breast discharge;
• Weight loss;
• Harmful blood clots in a vein or artery;
• Blood clots in the liver, stomach, intestine, kidneys or eye.

Do not take the Gedarel contraceptive pill if you have or have ever had any of the following:

• A blood clot in a blood vessel of your legs, your lungs or other organs;
• A disorder that affects your blood clotting;
• A heart attack or stroke;
• Angina pectoris or temporary stroke symptoms;
• Severe diabetes with vessel damage;
• Very high blood pressure;
• Very high level of fat in the blood;
• Hyperhomocysteinaemia;
• Severe migraine
• Migraine with aura;
• Liver disease;
• Abnormal liver function tests;
• Inflammation of the pancreas;
• Liver tumour;
• Gallstones;
• Unexplained vaginal bleeding;
• Endometrial hyperplasia;
• Pruritis;
• Porphyria, chorea, deteriorating osteosclerosis, herpes gestationis or pemphigoid during pregnancy;
• Hepatitis;
• Sex steroid influenced malignancy;
• Three or more missed periods (amenorrhea);
• Haemolitic uraemic syndrome;
• Pancreatitis.

You should also avoid the Gedarel contraceptive pill if you:

• Are pregnant or become pregnant;
• Had a baby less than six months ago;
• Are allergic to any of the ingredients listed on the packet.

Always discuss any medication you are taking with your doctor, including herbal remedies and supplements. Likewise, tell your doctor you are taking Gedarel if they are prescribing something new. Do not take the Gedarel contraceptive pill if you have hepatitis C and are taking products containing ombitasvir, paritaprevir, ritonavir and dasabuvir.

The Gedarel contraceptive pill may be less effective at preventing pregnancy in combination with medicines used to treat:

• Epilepsy;
• Tuberculosis;
• HIV infections;
• Hepatitis C virus infections;
• Fungal infections;
• Increased blood pressure;
• St John’s Wort can also affect Gedarel’s effectiveness.

The following medicines can affect the tolerability of the Gedarel contraceptive pill:

• Itraconazole, ketoconazole and fluconazole used to treat fungal infections;
• Macrolide antibiotics such as clarithromycin or erythromycin used to treat bacterial infections;
• Calcium channel blockers such as dilitiazem used to treat certain heart diseases and high blood pressure;
• Etoricoxib used to treat arthritis and arthrosis.

The Gedarel contraceptive pill may influence the efficacy of other medicines such as:

• Ciclosporin;
• Lamotrigine;
• Tizanidine;
• Levothyroxine;
• Theophylline.

You can get the Gedarel contraceptive pill from any reputable pharmacy, so you can order it either online or at your local pharmacy. In the UK, contraception is free on the NHS so you should not need to pay for your medication.

No, you will need to consult with a doctor and discuss your medical history to make sure Gedarel is the right contraception choice for you. The Gedarel contraceptive pill is a prescription-only medicine. You can visit your local doctor or family planning clinic or arrange an online consultation.

Harding, M. (2014). Combined Oral Contraceptive Pill (First Prescription) COCP. Patient. [online] Patient.info. Retrieved 15 January 2020 from https://patient.info/doctor/combined-oral-contraceptive- pill-first- prescription.

NHS UK (2017). Combined pill. [online] nhs.uk. Retrieved 15 January 2020 from https://www.nhs.uk/conditions/contraception/combined-contraceptive- pill/